Ministry Of Health Saudi Arabia

Elderly Health

Alzheimer's Disease

Overview:

Forgetfulness and Alzheimer's do not necessarily refer to the same thing. Alzheimer's is the degeneration of the parts of the brain that have to do with thinking, memory and speech. It is much more dangerous than forgetfulness.

While Alzheimer’s is not a natural stage of aging, the chances of developing the disease increase with age.
Alzheimer's is the most common form of dementia, and affects women more than men.
Despite the fact that Alzheimer's is an incurable disease, many treatments are available to help improve the patient's quality of life.
Patients go through several stages and symptoms that rarely appear at once. The disease progresses differently from one person to another.

Definition:

Alzheimer's destroys the brain's healthy cells, leading to a continuous degradation in memory and other cognitive skills. It is the most common reason for dementia that affects social and intellectual skills. It hinders daily activities and progresses over time.

Other names:

Dementia, senile dementia

Stages:

1. Early stage (unclear symptoms):

Difficulty finding the right word or name while talking;
Difficulty remembering the names of new people;
Difficulty completing social and professional duties;
Forgetting what was read a few moments earlier;
Loss of valuable items and placing them in the wrong places;
Difficulty planning and organizing.

2. Middle stage (onset of clear symptoms):

Difficulty remembering important events and personal history;
Mood swings and tendency to isolate oneself;
Difficulty remembering home address, personal phone number, or alma mater
Confusion regarding dates, the day of the week, season, place;
Needing help choosing the right clothes;
Some people face difficulty controlling their bowl movements;
Changes in sleeping habits;
The risk of getting lost in the street increases;
Changes in personality, e.g. paranoia, repeating some behavior (hands shaking or tearing napkins).

3. Advanced stage:

Constant need for care and monitoring;
Low awareness of things happening around the person;
Problems with physical abilities, e.g. walking and sitting or even swallowing;
Difficulty communicating with others
The patient may be at risk of infections at this stage, e.g. pneumonia.

Alzheimer's patients exhibit changes in their personality, such as:

Moodiness,
Distrust of others,
Increased stubbornness,
Social isolation,
Depression,
Fear,
Aggressiveness.

Causes:

Scientists believe Alzheimer's is the result of various genetic factors and other factors related to lifestyle and the surrounding environment. It is very difficult to pinpoint causes and factors behind Alzheimer's, but its effect on brain cells is clear: it targets and destroys brain cells.

How does Alzheimer's disease develop?

Scientists have observed the following signs in Alzheimer's patients:

Decrease in brain the number of cells, and decreased links among them, compared with a healthy brain;
Accumulation of beta-amyloid proteins in the brain, often called "plaques", that undermine neural connections between the cells and may stimulate the immune system to attack neurons;
The formation of ‘tangles’ as a protein called ‘tau’ twists and forms an obstacle that prevents nutrients from reaching live cells until they die.

Risk factors:

Age: Alzheimer's usually develops in people aged over 65 years old. In very rare cases, though, the onset of the disease may occur at an earlier age.
Genetic factors: If someone in the family has Alzheimer's, there is a higher possibility that his/her first-degree relatives (sons/daughters, brothers/sisters) may be affected.
Gender: Women are at higher risk than men.
Lifestyle: Factors that increase the risk of heart disease also increase the risk of Alzheimer's.
Educational and cultural background: Studies have found a link between low education levels and Alzheimer's, but the exact cause related to education remains unknown.
Head Injuries
Learning difficulties
Down Syndrome

Symptoms:

Alzheimer's usually begins in the form of weakened memory, followed by a progressive difficulty in completing daily tasks. The disease progresses differently from a person to another, till its final stages. It is scientifically established that some patients reach the final stage within 3-4 years, while others may take up to 15 years to reach the same stage.

Complications:

During the advanced stages of Alzheimer's, the patient loses the ability to take care of him/herself. From this, several other medical problems arise, such as:

Respiratory infections: Difficulties swallowing food and liquids may lead to some food or drink products entering the respiratory pathway, through to the lungs, probably leading to pneumonia.
Urinary infections: As the patient struggles to control his/her urine, a urinary catheterization may be necessary, increasing the risk of urinary tract infections.

Falling injuries: Falling may lead to fractures and is a common cause of serious head injuries such as brain hemorrhages.

Diagnosis:

Doctors are able to diagnose 90% of Alzheimer's cases accurately. The condition can be confirmed after death through the microscopic testing of brain cells to identify plaques or tangles.

To distinguish Alzheimer's from the other causes of memory loss, doctors usually conduct the following tests:

Laboratory tests
Neuropsychological tests
Brain scans
MRI scans
CT scans

Treatment:

Alzheimer's so far: Neurologists sometimes prescribe medication to limit the symptoms that often accompany Alzheimer's, including sleeplessness, tossing, anxiety, insomnia, and depression.

Family role:

All family members should be informed about the nature of Alzheimer's and its progression.
Roles should be assigned to care for the patient based on the individuals' situations and time.
Patients benefit from short and repeated visits from loved ones.

Prevention:

Since the risk factors of Alzheimer's are similar to those of heart diseases, controlling these factors can help prevent the disease. These factors include: hypertension, cholesterol levels, and blood sugar levels.
Regular physical, mental and social training can reduce the risks of Alzheimer's.
The head should be protected from injuries or traumas by wearing a seatbelt or a helmet when playing sports.

FAQ:

1. Does caffeine (in tea or coffee) protect against Alzheimer's?

No studies have confirmed caffeine's effect in preventing Alzheimer's disease.

Myths & Truths:

Memory loss (forgetfulness) is normal and is linked to aging.

Truth: To forget is natural in humans. It's normal to forget a few things about some aspects of life but most people often remember them later. In the case of Alzheimer’s, memory loss becomes clearer and severer, because of disorders in the brain leading the person to forget the names of loved ones and daily routine events.

Alzheimer's only affects the elderly.

Truth: Alzheimer's doesn't only affect the elderly. In some cases, people in their 30s, 40s or 50s can suffer from Alzheimer's. This is called Early Onset Alzheimer's.